Retrospective analysis of the influential factors of lymph node metastasis in 280 cases of cT1aN0M0 lung cancer

Abstract

Objective To investigate the risk factors of lymph node metastasis in cT1aN0M0 lung adenocarcinoma. Methods The clinical data of 280 cases of cT1aN0M0 lung adenocarcinoma admitted from January 2013 to December 2015 were selected, and the lymph node metastasis and clinical factors were retrospectively analyzed. The pathological characteristics and clinical data of the patients, combined with single factor and multiple factors analysis, the influence factors of lymph node metastasis of cT1aN0M0 lung adenocarcinoma were investigated. Results Thin slice CT scan found that 108 cases (38.6%) with the lung CT image typology for pure ground glass opacity, and 117 cases (41.8%) with CT imaging type of ground glass opacity (solid component diameter<5 mm), 12 cases (4.3%) with CT imaging type of part solid nodules (solid component diameter greater than or equal to 5 mm), 43 cases (15.4%) with the CT images of pure solid nodules. There were 28 patients (10.0%) with lymph node metastasis, among which 16 patients (5.7%) with N1 lymph node metastasis and 12 patients (4.3%) with N2 lymph node metastasis. In this study, the patients with diameter less than 5 mm and CT imaging of pure ground glass opacity didn’t have lymph node metastasis after surgery. Conclusions Clinical cT1aN0M0 lung adenocarcinoma patients, if the imaging performance of pure grinding glass or solid components of the diameter is less than 5 mm, there is usually no lymph node metastasis occurred. The tumor diameter greater than 1 cm, mixed nodules and solid nodules and CEA>5 μg/L were important prognostic factors for lymph node metastasis. Analysis of the maximum standard uptake value in patients with PET-CT show that patients are more likely to have lymph node metastasis, when the maximum standard uptake value is greater than 5. Key words: Lung cancer; Lymph node; Lymph node metastasis; Clinical predictors; Clinical stage